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Engaging in 'reflexive practice' throughout the research process (Benson and O'Reilly, 2022) and a 'reflexivity of discomfort' (Hamdan, 2009) through an intersectional lens, this article presents a reflective account of accessing and conducting observations and interviews at a South Asian women's organisation, in North England, to explore Pakistani and Bangladeshi Muslim (PBM) lone motherhood. It critically explores how researchers' own subjectivities and intersecting identities – in this case, my intersecting identities and positionalities as a young British Pakistani Muslim women, researcher and volunteer – impact interactions in different circumstances with different groups of participants and the importance of having continuous critical self-awareness. Moving beyond simplistic insider–outsider debates, the paper contributes towards further developing reflexivity debates taking an 'intersectional reflexivity' approach. It argues for thinking about the research process and engagements in the field as socially constructed, changing, adapting and negotiated overtime and to utilise intersectionality to unpick broader categories. Finally, it encourages researchers to adopt reflexivity in their research practices. [ABSTRACT FROM AUTHOR]

Microcredit emerged in the 1970s, in Bangladesh, as a tool for sustainable development. However, in Portugal, it only took its first steps in the late 1980's and emerged as a response to unemployment. This paper provides an overview of micro credit system in Portugal and aims to identify the profile of the successful microentrepreneur and point out the reasons that most contribute to the sustainability of microcredit business initiatives. Although the paper is mainly exploratory, we combined different methodologic approaches. First, we conducted interviews with key informants, then, we applied a questionnaire to microentrepreneurs. The survey contained three sections, namely, socio-demographic characteristics; characteristics of project; attitude as an entrepreneur. A sample group consisting of 96 participants of microfinance programme participated in the research. The findings indicate that the profile of the successful microentrepreneur is an individual with a superior degree, already have been employed, with positive or very positive level for the innovation of the product/service, for the adjustment of the business to the environment, for prior planning and for the accompaniment by public/non-profit institution. In a less degree, a positive level for training/professional experience in the project area and a positive level for self-esteem/self-confidence have also some influence. The results point out that the attitude as a microentrepreneur is less important than the characteristics of the project to the outcome of the microenterprise. [ABSTRACT FROM AUTHOR]

INTRODUCTION Bangladesh has 22 million adult users of smokeless tobacco (ST). The prevalence among women is higher (24.8%). Health-related quality of life outcome (HRQoL) for ST use is little known. We investigated the association between HRQoL and daily ST use among adult women in Bangladesh. METHODS Using multi-stage design, a cross-sectional survey was conducted. Adult women (randomly selected) were surveyed from 4 purposively selected divisions (Dhaka, Chittagong, Khulna and Rangpur). Female ST users and non-users were compared using HRQoL scores. Self-perceived Visual Analogue Scale (EQ-VAS) values and HRQoL scores were modelled to examine their association with ST use. RESULTS A total of 2610 women (1149 users and 1461 non-users) were surveyed. The proportion reported any type of problem in all health dimensions was significantly higher among female ST users than non-users (mobility: 43.3% vs 19.5%, self-care: 29.6% vs 11.9%, usual activities: 48.7% vs 21.8%, pain or discomfort: 69.8% vs 40.6%, and anxiety or depression: 61.3% vs 37.5%). The average HRQoL scores were 0.79 (95% CI: 0.78-0.81) and 0.90 (95% CI: 0.89-0.90) for users and non-users, respectively. Moreover, EQ-VAS average values were significantly higher for non-users [80.7 (95% CI: 79.9-81.6) vs 70.27 (95% CI: 69.2-71.2)]. Controlling the sociodemographics, ST use significantly reduced the HRQoL score by an average of 0.15 points. The EQ-VAS values on average decreased by 0.04 points for ST use. CONCLUSIONS ST use is significantly associated with the HRQoL of females in Bangladesh. Considering the higher prevalence of ST, especially among women, HRQoL hazards need to be communicated for awareness building. [ABSTRACT FROM AUTHOR]

Objective - Taxation is the government's primary source of revenue, but it is unable to raise this revenue from the general public. The major goals of this article are to determine the taxpayers' attitudes toward income tax in Bangladesh, as well as the factors influencing taxpayers' behavioral intentions regarding tax evasion and avoidance. Both qualitative and quantitative research methods were used in this study. Methodology/Technique - The respondents' primary data was acquired by a standardized written questionnaire and a face-to-face viva. To complete the job, the study used purposeful random sampling, which resulted in the selection of 150 individuals from various occupations. After gathering data, it was examined using several statistical methods. Findings - The study's findings reveal a significant negative relationship between taxpayer attitudes regarding tax evasion and tax compliance behavior, as well as the fact that taxpayer attitudes and conduct differ by occupation, resulting in diverse tax evasion and avoidance trends. Novelty - This study will aid the government authority and the National Bureau of Revenue in monitoring taxpayer attitudes and improving tax collection by reducing taxpayers' negative attitudes toward taxes and getting more people to file tax returns. [ABSTRACT FROM AUTHOR]

Purpose: A number of initiatives have been developed to ensure easy access to mental health services for Black and Asian Minority Ethnic (BAME) communities. Improving Access to Psychological Therapies (IAPT) is a service that delivers first line interventions for South Asian women; however, little is known about what makes IAPT accessible for this population. This paper aims to explore South Asian women's experiences of accessing psychological therapy and whether therapy within IAPT helps individuals to re-frame their experiences within their own cultural context. Design/methodology/approach: A qualitative approach was used. Semi-structured interviews were carried out with South Asian women who accessed an IAPT service. Ten participants took part in the study and interviews were analysed using thematic analysis. Findings: Six themes were identified; access, experience, cultural framework, therapist characteristics, expectations and "sticking with it". Having a good therapeutic relationship with the therapist was key. While cognitive behavioural therapy (CBT) enabled clients to manage their symptoms, manualised CBT led to a sense of dissatisfaction for some. Clients spoke of having to make a forced choice to either deny their culture or leave their culture at the door to access therapy. Cultural and religious exclusion had a negative impact on therapy particularly for those whose difficulties were related to their cultural or religious context. Practical implications: Culture and religion continues to be excluded from psychological therapy for South Asian Women. A cultural shift is required from within IAPT services to maintain engagement for this group. Further clinical implications are discussed. Originality/value: While the experiences of Black and Asian ethnic minority groups accessing secondary mental health services has been explored, this study explores and highlights the experiences of South Asian Women accessing therapy in primary care, and uniquely identifies the processes that enable women to engage in therapy. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to identify the critical determinants of Bangladeshi small and medium-sized enterprises' intention to continue their business. 1724 business owners participated as respondents in this survey. Using logistic regression, our results suggest that continuance intention is affected positively by innovation, informality, risk attitude, and debt. On the other hand, the age of the business owner and the size of firm do not play any significant role in this intention. The probability of continuance in the presence of each of these factors is also calculated in Manufacturing, Service, and Trade sectors separately. Understanding the influential determinants of continuance intention of business owners would help the policy makers to devise appropriate policies from a better insight to support the industry in different sectors. [ABSTRACT FROM AUTHOR]

The paper aims at expanding the TPB model to examine the relationship among attitude, subjective norms, perceived behavioural control, motivation, and behavioural intention as well as the extent to which satisfaction mediates the relationship in the link between TPB predictive constructs along with motivation and behavioural intention. A questionnaire survey technique was administered on d omestic tourists and subsequently, structural equation modeling using SmartPLS 3.0 was subjected to test the synthesized relationship among va riables. The study findings support that attitude, subjective norms, and motivation significantly influence customer satisfaction and behavioural intention whereas perceived behavioural control does not. In addition, the study indicates that customer satisfaction mediates in the link between attitude, subjective norms, and motivation, and behavioural intention. However, despite the availability of international tourists, the study selected only domestic tourists that are liable for future research. Moreover, the findings of the study will enhance the understanding of hospitali ty researchers and managers what will significantly influence customer satisfaction and behavioural intention. [ABSTRACT FROM AUTHOR]

Since August 2017, approximately one million Rohingya people from Myanmar have fled from genocide, gender-based violence and torture in northern Rakhine state, Myanmar to Cox's Bazar in neighbouring Bangladesh. International and local humanitarian agencies are now attempting to support the health and mental health needs of over 1.3 million people who are dependent on aid, including the host communities. This reflection paper considers diasporic and transnational belonging issues emerging from being an international consultant who is also Bangladeshi by origin, and the cross-learning processes that emerged through working with local services. Given the recognition that historically western narratives are privileged over non-western knowledge and experiences, key learning around this interface and the necessity of reflective and ethical practice competencies are outlined. Working with local services in humanitarian settings involved a congruence with a personal--professional value base, and a humility, openness, self-awareness and reflexivity. The importance of reflective and ethical practice competencies is discussed in the context of delivering effective and culturally congruent, meaningful and useful interventions. The paper outlines key learning and reflections from supporting work in the Rohingya camps in Bangladesh, and how this learning might apply to clinical practice in humanitarian and development settings. [ABSTRACT FROM AUTHOR]

Purpose -- This paper's aim is to inspect the influence of trust, motivation and rewards on knowledge-sharing attitudes among secondary and higher secondary students in Bangladesh. Design/methodology/approach -- A sample of 200 Bangladeshi students from secondary and higher secondary-level educational institutions in Dhaka city participated in this study. Data were analysed using exploratory factor analysis followed by confirmatory factor analysis and structural equation modelling techniques. Findings -- The findings suggested that trust variables play a significant role in encouraging knowledge-sharing behaviour among the students. Practical Implications -- This research also provides a guideline to teachers and policymakers on enhancing a knowledge-sharing environment among secondary and higher secondary-level students. Originality -- This paper is a pioneer in understanding knowledge-sharing patterns among secondary and higher secondary students in a developing country such as Bangladesh. [ABSTRACT FROM AUTHOR]

In line with a current global trend, junior secondary science education in Bangladesh aims to provide science education for all students to enable them to use their science learning in everyday life. This aim is consistent with the call for scientific literacy, which argues for engaging students with science in everyday life. This paper illustrates Bangladeshi science teachers' perspectives of scientific literacy along with their views on teaching practices. Participating teachers held a range of perspectives of scientific literacy, including some naive perspectives. The paper also reports that whilst teachers' verbalised practices in relation to their emphasis on engaging students with science in everyday life follows the emphases as required in teaching for promoting scientific literacy, their assessment practices may not be useful to promote it. The discussion explores the meaning of these findings and provides implications for school science educational practice in Bangladesh. [ABSTRACT FROM AUTHOR]

After decades of presuming that climate adaptation is a private good benefitting only those receiving resources to reduce individual climate risks, respondents in a survey experiment among the climate-vulnerable in Bangladesh chose less-particularistic adaptation projects than "electoral connection" disaster relief theories predict and more "short-sighted" projects than international diplomats anticipate. This article reports on the experiment, which asked a representative national sample of Bangladeshis whether they favor spending funds on short-term particularistic solutions (disaster relief stockpiles), medium-term inclusionary and non-excludable solutions (ocean embankments), or long-term, public goods solutions (the development of flood-resistant rice seeds). More respondents chose "middle ground" embankment spending, and a statistically significant change in respondent propensities was tied to their lived experience with climate vulnerability rather than electoral incentives. The logic of their choices contradicts existing explanations, implying that a reconsideration of vulnerable community preferences, and how to address them, may be needed. [ABSTRACT FROM AUTHOR]

Snakes are a natural form of pest control that play an essential role in the ecosystem's balance. Snakes can provide an ecological service to people by lowering insect populations that can spread disease and harm agricultural produce. Because snakes assist us in so many ways, they have long been the subject of torture and unfavorable views across cultures, and humans threaten many. However, little is known about how snake charmers in developing nations like Bangladesh are changing their attitudes and behavior toward snakes. This study aims to examine the snake charmer community in northern Bangladesh's changing attitudes and behavior toward snakes. Snake predictors must be better understood to improve conservation efforts. This study examined whether knowledge of mortality from snakebites, experience with snakebites, myth beliefs about snakes, and education level predict attitudes toward snakes in the northern area of Bangladesh. The results of the ordinal regression model revealed that beliefs in hatred, fear, and the myth that snakes are evil are related to less tolerance of snakes. We also examined attitudes that would predict the intended killing of snakes. Snake tolerance was linked to more frequent snake interactions and a lower level of education. Even after controlling for the influence of other psychological and experience-based variables, better snake tolerance and lower education were linked to a decreased risk of purposefully killing snakes. More education and sustainable wildlife management should be used to change people's attitudes and stop them from killing snakes on purpose. [ABSTRACT FROM AUTHOR]

Background: We aimed to examine the influence of witnessing father-to-mother violence on: 1) perpetration of intimate partner violence (IPV); and 2) endorsement of attitudes justifying wife beating in Bangladesh.Methods: This paper used data from the 2007 Bangladesh Demographic Health Survey. The analyses were based on the responses of 3374 ever-married men. Exposure to IPV was determined by men's self-reports of witnessing inter-parental violence in childhood. We used adjusted binary logistic regression models to assess the influence of exposure on husbands' perpetration of IPV and their endorsement of attitudes justifying wife beating.Results: Nearly 60% of men reported violent behaviour towards an intimate partner and 35.7% endorsed attitudes justifying spousal abuse. Men who witnessed father-to-mother violence had higher odds of reporting any physical or sexual IPV (adjusted OR [AOR] = 3.26; 95% CI = 2.61, 4.06). Men who had witnessed father-to-mother violence were also 1.34 times (95% CI = 1.08, 1.65) more likely endorse attitudes justifying spousal abuse.Conclusions: Committing violence against an intimate partner is an all too frequent practice among men in Bangladesh. The study indicated that men who had witnessed father-to-mother violence were more likley to perpetrate IPV, suggesting an intergenerational transmission of violence. This transmission of violence may operate through the learning and modelling of attitudes favourable to spousal abuse. In support of this, witnnessing inter-parental violence was also associated with the endorsement of attitudes justifying spousal abuse. Our findings indicate the continued importance of efforts to identify and assist boys who have witnessed domestic violence and suggest such efforts should aim to change not just behaviours but also attitudes that facilitate such violence. [ABSTRACT FROM AUTHOR]

Background: Physical activity is important for the control of high blood pressure (hypertension). We aimed to investigate the associations of current physical activity levels, sedentary time, knowledge of and attitude towards physical activity with blood pressure in people with hypertension in a rural area in Bangladesh. Methods: A total of 307 adults aged 30 to 75 years with hypertension were recruited from the Banshgram Union of Narial district as part of a cluster-randomized control trial. Current blood pressure was measured as the outcome variable. Associated variables included physical activity at work, travel to and from places, recreational activity, metabolic equivalent task (MET)-min, sedentary time, and awareness of and attitudes towards physical activity. Rasch analysis was used to compute a combined score from the five awareness of and attitudes towards physical activity items and categorized into 0–40 (towards negative attitude), 41–60 score (mixed attitude) and 61–100 (positive attitude). We used a generalised linear model to analyze the data. Results: Participants (n = 68, 22.1%) who engaged in vigorous-intensity physical activity that causes large increases in breathing or heart rate like carrying or lifting heavy loads, digging or construction work for at least 10 minutes continuously had lower systolic blood pressure (SBP) (mean (95% confidence interval (CI)), 143.6 (140.1, 147.2)) compared to those who did not take part in a vigorous-intensity physical activity (mean (95% CI), 150 (147.6, 152.3)). MET-min less than 600 min/week was significantly associated with higher SBP 153.8 (148.1, 159.6) than MET-min 600–2999 min/week 148.0 (143.0, 152.9) and MET-min>3000 min/week 146.9 (144.5, 149.3), p = 0.001 for trend. Sitting time more than four hours a day was associated with higher DBP 91.4 (89.7, 93.0) compared to those who had sitting time less than fours a day 88.6 (87.1, 90.1). People with positive attitudes were associated with a reduced SBP of 10.6 (0.36, 20.8) mmHg and DBP 5.88 (0.47, 11.3) compared to the people who had a negative attitude towards taking part in physical activity. Conclusions: Participating in high physical activity and positive attitudes towards physical activity were associated with lower blood pressure levels. Physical activity awareness programs should be implemented to increase awareness of health benefits and increase participation in high physical activity. [ABSTRACT FROM AUTHOR]

This study investigates the attitudes, perceptions and practices of pleasure reading among the undergraduate and graduate students of Dhaka University. Undergraduate and Graduate students under three major faculties i.e. Arts and Social Sciences; Business Studies; and Science, Engineering & Technology have been selected to participate in this survey. A total of 300 questionnaires have been distributed among the interested participants and the libraries of the concerned faculties were selected for selecting respondents randomly. Systematic random sampling method has been deployed for the convenient of the study. Data analysis has been done using SPSS Version 25 and MS Excel. The study investigates the following topics: attitudes and understanding of pleasure reading among the students; the correlation between pleasure reading and academic achievement; whether the library could play a significant role in promoting pleasure reading. This study suggests that the students of Dhaka University have the habit of pleasure reading. The undergraduate and graduate students of Dhaka University confess that pleasure reading helps them to get mental peace and sanity at the same time being positive. They also acknowledge that pleasure reading helps them in achieving academic success, acquiring new knowledge and developing vocabulary base. One of the key findings of the study is that students are very much career-centric and they spend most of their time reading job-seeking guidebooks. The study is the first endeavor to investigate the pleasure reading trends and attitudes among the students of Dhaka University that may prompt future research on Bangladeshi students regarding pleasure reading. [ABSTRACT FROM AUTHOR]

This study aimed to provide the very first description of the current scenario of knowledge, attitudes, and practices (KAP) concerning the food safety and hygiene subjects among wet fish handlers (WFHs) and dry fish handlers (DFHs) in Cox's Bazar, Bangladesh. Data collection was performed through the application of face‐to‐face interviews with 234 WFHs and 258 DFHs. The overall score of the correct answer assessed components was 55.95% and 57.05% in WFHs and DFHs, respectively. Among the different knowledge categories, both the respondents showed the highest positive response in the time, temperature, and quality control category and the lowest positive responses noted in the foodborne disease occurrence category. For attitudes, obtained results showed positive attitude with a mean score of 37.82 ± 4.28 and 35.58 ± 5.48 for WFHs and DFHs, respectively. The WFHs gained a mean score of 23.08 ± 4.24 for practices, and the score was 22.78 ± 4.47 in the case of DFHs. A positively significant correlation coefficient (rs) was observed among fish handlers' KAP of 0.326–0.584. Although the association between the three levels was acceptable, several food safety principles and hygiene practices remained unsatisfactory. These findings highlighted the need for rapid action to enhance food safety and hygiene KAP through an intensive training program to assure the production of safe fisheries products for human consumption. [ABSTRACT FROM AUTHOR]

Background: Self‐management strategies improve asthma outcomes, although interventions for South Asian populations have been less effective than in White populations. Both self‐management and culture are dynamic, and factors such as acculturation and generation have not always been adequately reflected in existing cultural interventions. We aimed to explore the perspectives of Bangladeshi and Pakistani people in the United Kingdom, across multiple generations (first, second and third/fourth), on how they self‐manage their asthma, with a view to suggesting recommendations for cultural interventions. Methods: We purposively recruited Bangladeshi and Pakistani participants, with an active diagnosis of asthma from healthcare settings. Semi‐structured interviews in the participants' choice of language (English, Sylheti, Standard Bengali or Urdu) were conducted, and data were analysed thematically. Results: Twenty‐seven participants (13 Bangladeshi and 14 Pakistani) were interviewed. There were generational differences in self‐management, influenced by complex cultural processes experienced by South Asians as part of being an ethnic minority group. Individuals from the first generation used self‐management strategies congruent to traditional beliefs such as 'sweating' and often chose to travel to South Asian countries. Generations born and raised in the United Kingdom learnt and experimented with self‐management based on their fused identities and modified their approach depending on whether they were in familial or peer settings. Acculturative stress, which was typically higher in first generations who had migration‐related stressors, influenced the priority given to asthma self‐management throughout generations. The amount and type of available asthma information as well as social discussions within the community and with healthcare professionals also shaped asthma self‐management. Conclusions: Recognizing cultural diversity and its influence of asthma self‐management can help develop effective interventions tailored to the lives of South Asian people. Patient or Public Contribution: Patient and Public Involvement colleagues were consulted throughout to ensure that the study and its materials were fit for purpose. [ABSTRACT FROM AUTHOR]

Telemedicine ensures quality, cost-effective, and equally accessible healthcare services for everyone. Nonetheless, a poor usage rate could curb its progression in developing cultures like Bangladesh. Therefore, this research examines how external stimuli promote the continuous usage intentions of synchronous telemedicine services through engagement and satisfaction by deploying the stimulus-organism-response framework. A final sample of 312 telemedicine users was analyzed using the structural equation modeling in AMOS. The average age of the participants was 26.28 (std. deviation 5.53), and their average use of telemedicine was 2.39 times (std. deviation 1.31) over the last six months. This study empirically endorsed that the stimuli, including performance expectancy, information quality, and contamination avoidance, as well as organismic factors such as engagement and satisfaction, directly impacted the continuance desires for telemedicine use. In addition, the analyses validated the mediation roles of engagement and satisfaction. Furthermore, performance and effort expectancies influenced engagement, which affected satisfaction along with performance expectancy, functionality, and information quality. Accordingly, telemedicine facilitators should integrate these critical attributes into the system to sustain engagement, satisfaction, and usage intentions. This study has pioneered the effects of performance and effort expectancies on continuous usage intentions facilitated by engagement and satisfaction in the telemedicine landscape. [ABSTRACT FROM AUTHOR]

The tendency of a person to frequently use public (i.e., historical) events as temporal landmarks when dating personal memories is termed the living-in-history (LiH) effect. We investigated the LiH effect in autobiographical memories of Bangladeshi older adults who lived through the 1960s Bengali nationalist movement and the 1971 Bangladesh War of Independence. 476 participants (mean age = 67.16 years; SD = 5.96 years), including 62 independence war veterans, retrieved and dated three important memories from their life and completed two scales: (a) a transitional impact-of-war scale and (b) a generational identity scale. Results showed that nearly one-third of the total memories (32%) were dated using public event references, demonstrating a LiH effect. However, this effect was twice as strong among veterans (58%) than among nonveterans (28%). The memory content analysis revealed that public event references were mostly used to date public memories (e.g., war and political struggle) and the memories with negative valence. Multivariate analyses showed that veteran identity, material changes due to war and participants' age significantly predicted the use of public event references to date one, two or three memories relative to no use of those references. The public memories that were personally significant and the extent participants experienced the material changes due to war mainly caused the LiH effect. We discuss the results considering current theories of autobiographical memory. [ABSTRACT FROM AUTHOR]

Background: Perinatal mental health (PMH) is a worldwide public health issue crossing cultural boundaries. However, the prevalence of PMH conditions vary considerably. These disparities stem in part from poor understanding and stigma surrounding PMH which hinder pregnant women from seeking mental health care and may exacerbate their conditions. Bangladesh, India and Pakistan are South Asian countries with a higher burden of PMH conditions than in the Global North-West and very different social and cultural norms around gender and mental health. The aim of this systematic review (PROSPERO Ref: CRD42020167903) was to identify, synthesise and appraise the available literature on perceptions and attitudes of perinatal (pregnant and postpartum) women, their families and healthcare providers surrounding PMH in Bangladesh, India and Pakistan. Methods: Five electronic databases, MEDLINE, Embase, PsycINFO, Scopus and Web of science, and grey literature were searched using predefined search terms. Qualitative or quantitative articles with a qualitative component reporting perceptions and attitudes surrounding PMH in Bangladesh, India and Pakistan were eligible for inclusion, if published in English between January 2000 and January 2021. The Critical Appraisal Skills Programme Qualitative Research Checklist and Newcastle–Ottawa Scale for cross-sectional studies were used to assess study quality. Findings were synthesised using thematic synthesis, as described by Thomas and Harden 2008. Results: Eight studies were included. Five overarching themes comprising 17 sub-categories were identified. These descriptive themes were: perceived causes of PMH, perceived symptoms of PMH, perceptions of motherhood, accessing PMH care and emotional sharing and coping strategies. Sociocultural expectations underpin many of the themes identified in this review including the importance of familial and societal causes of PMH, emphasis on physical symptoms, sacredness of motherhood, lack of awareness, stigma, shame, limited resources allocated for mental health and lack of emotional sharing. Conclusions: There is a complex range of perceptions and attitudes around PMH which influence women's experiences and access to PMH care. These findings will inform policy and practice through targeted interventions to tackle stigmatising attitudes and increasing education and training for healthcare providers. [ABSTRACT FROM AUTHOR]

Background: Countrywide lockdown or stay-at-home order has been implemented to slow down the transmission of emergent coronavirus. However, the influence on attitudes and lifestyle due to lockdown amidst the coronavirus disease 2019 (COVID-19) pandemic has been poorly understood. The present study aimed to investigate the influence on attitudes and lifestyle due to lockdown amidst the COVID-19 pandemic among Bangladeshi residents.Methods: A cross-sectional survey carried out involving 1635 community dwellers across eight divisions in Bangladesh conducted from April 15, 2020 to May 10, 2020. A structured questionnaire incorporating socio-demographic, attitudes towards lockdown and adverse lifestyle amidst lockdown measures was employed to collect data using the Google Forms. Multiple regression analyses were executed to determine the associated factors of positive attitudes towards lockdown and adverse lifestyle.Results: The mean scores of attitudes towards lockdown were 67.9 (SD = 8.4) out of 85 with an overall correct rate (positive attitudes) of 79.9%; whereas the mean scores of adverse lifestyle amidst lockdown were 16.1 (SD = 4.8) out of 34 with an overall rate of 47.4%. The factors associated with more positive attitudes towards lockdown included being female, divorced, higher educated, and students. Conversely, being male, having no formal education, and rural residence were associated factors of adverse lifestyle amidst the COVID-19 pandemic.Conclusions: The findings reflect how the COVID-19 lockdown has preciously impacted the attitudes, and lifestyle of Bangladeshi citizens, which will contribute to promoting appropriate measures during a subsequent zonal or complete lockdown. [ABSTRACT FROM AUTHOR]

Affective variables such as attitude, autonomy, motivation, self-esteem, and anxiety are crucial among the factors that contribute to learning a second/foreign language. Among them, one of the most important factors in inspiring learners to learn a language is their attitudes towards learning. The purpose of this study was to examine the cognitive, emotional as well as behavioral attitudes of Bangladeshi Aliya madrasah students towards learning English. The study also explored the differences in their attitudes towards learning English based on demographic profiles, that is, their gender, their parents' monthly family income, and their parents' education level. Data were obtained via questionnaire surveys and they were analyzed quantitatively using descriptive statistics, independent T-test, and one-way ANOVA. The results revealed that the participants demonstrated highly positive cognitive, emotional, and behavioral attitudes towards learning English. The analysis also showed that there was a statistically significant difference in the students' attitudes towards learning English based on their parents' monthly family income and their parents' education level. However, the results presented no significant difference in the students' attitudes towards learning English in relation to gender. This finding may help teachers to improve their classroom preparation by understanding their students' attitudes better and making the learning activities easier for them. Moreover, it may inform the students' attitudes to the authorities and policymakers responsible for devising policy for madrasah education, planning curriculum and designing materials for the madrasah students. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore the effects of perceived paternal and maternal acceptance on the bicultural orientations and psychological adjustment of ethnic-minority young adults in Bangladesh. The study was based on a sample of 412 young adults (mean age 22 years), consisting of 40% women and 60% men from 18 tribal subgroups in Bangladesh. Measures used were Parental Acceptance-Rejection Questionnaire (PARQ), Bicultural Attitude Scale (BAS) and Personality Assessment Questionnaire (PAQ). Results showed that there are significant positive correlations between perceived parental (paternal and maternal) acceptance, heritage culture, and psychological adjustment of the respondents. Results further showed that perceived paternal acceptance has independent and stronger effect than perceived maternal acceptance on the bicultural orientations and psychological adjustment of the minority young adults in Bangladesh. [ABSTRACT FROM AUTHOR]

Background: Dietary supplements (DS) are products that improve the overall health and well-being of individuals and reduce the risk of disease. Evidence indicates a rising prevalence of the use of these products worldwide especially among the age group 18–23 years. Aim: The study investigates the tendencies and attitudes of Bangladeshi undergraduate female students towards dietary supplements (DS). Methods: A three-month (March 2018-May 2018) cross-sectional face-to-face survey was conducted in undergraduate female students in Chittagong, Bangladesh using a pre-validated dietary supplement questionnaire. The study was carried among the four private and three public university students of different disciplines in Chittagong to record their prevalent opinions and attitudes toward using DS. The results were documented and analyzed by SPSS version 22.0. Results: Ninety two percent (N = 925, 92.0%) of the respondents answered the survey questions. The prevalence of DS use was high in undergraduate female students. The respondents cited general health and well-being (n = 102, 11.0%) and physician recommendation (n = 101, 10.9%) as a reason for DS use. Majority of the students (n = 817, 88.3%) used DS cost monthly between USD 0.12 and USD 5.90. Most of the students (n = 749, 81.0%) agreed on the beneficial effect of DS and a significant portion (n = 493, 53.3%) recommended for a regular use of DS. Highly prevalent use of dietary supplements appeared in Chittagonian undergraduate female students. They were tremendously positive in using DS. The results demonstrate an increasing trend of using DS by the undergraduate females for both nutritional improvement and amelioration from diseases. Conclusion: Dietary supplements prevalence was so much higher in students of private universities as compared to students of public universities. Likewise, maximal prevalence is indicated in pharmacy department compared to other departments. Students preferred brand products, had positive opinions and attitudes towards dietary supplements. [ABSTRACT FROM AUTHOR]

Background Bangladesh experienced its worst dengue fever (DF) outbreak in 2019. This study investigated the knowledge, attitudes and practices (KAP) among university students in Bangladesh and significant factors associated with their prevention practices related to climate change and DF. Methods A social media–based (Facebook) cross-sectional KAP survey was conducted and secondary data of reported DF cases in 2019 extracted. Logistic regression and spatial analysis were run to examine the data. Results Of 1500 respondents, 76% believed that climate change can affect DF transmission. However, participants reported good climate change knowledge (76.7%), attitudes (87.9%) and practices (39.1%). The corresponding figures for DF were knowledge (47.9%), attitudes (80.3%) and practices (25.9%). Good knowledge and attitudes were significantly associated with good climate change adaptation or mitigation practices (p<0.05). Good knowledge, attitudes and previous DF experiences were also found to be significantly associated with good DF prevention practices (p<0.001). There was no significant positive correlation between climate change and DF KAP scores and the number of DF cases. Conclusions Findings from this study provide baseline data that can be used to promote educational campaigns and intervention programs focusing on climate change adaptation and mitigation and effective DF prevention strategies among various communities in Bangladesh and similar dengue-endemic countries. [ABSTRACT FROM AUTHOR]

Currently, around a million Rohingya refugees live in Cox's Bazar, Bangladesh. This study examines the attitudes toward physical abuse and experiences of intimate partner violence (IPV) of Rohingya refugee women who experienced child marriage. A cross-sectional survey was conducted in the Rohingya refugee settlement at Cox's Bazar, Bangladesh. Attitudes towards physical abuse have been assessed by a set of five questions that asked the situation under which 'hitting or beating' one's wife is justifiable. Multivariable logistic regressions are used to examine the associations of exposure to child marriage with (i) attitudes towards the justification of physical abuse by one's husband and (ii) experiences of IPV in the 12 months prior to the survey. Data are available for 486 participants. Overall, 61.32% of women experienced child marriage (married before 18 years of age) and they were more likely to have strongly justified beatings/hitting one's wife under certain circumstances (Adjusted Odds Ratio (AOR) = 2.71; 95%CI: 1.78, 4.11), and to have experienced such IPV by their husbands in the 12 months prior to the survey (AOR = 1.72; 95%CI: 1.13, 2.61). These AORs are higher for women married at ages 12–14 than those married at 15–17. Having some formal education among husband and wife is protective of abuse within a marriage. Rohingya women's attitudes towards and experiences of IPV are associated with their exposure to child marriage. Interventions for stopping child marriage, marriage registration, social support group, and legal interventions are needed. Offering formal education to all children needs to be prioritized. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the knowledge and attitudes towards COVID-19 in Bangladeshi adults by online and phone survey methods during the early stage of its spread. Methods: Data were collected through phone calls (April 14-23, 2020) and online survey (April 1819, 2020) in Bangladesh. The questionnaire had 20 knowledge questions with each correct response getting one point and incorrect/don't know response getting no point (maximum total knowledge score 20). Participants scoring >17 were categorized as having good knowledge. Results: The percentages of good knowledge holders were 57.6%, 75.1%, and 95.8% in the phone, online non-medical, and online medical participants, respectively. Most of the phone and online participants had good knowledge of the preventive practices of COVID-19. However, among the non-medical participants (both phone and online), the correct response rates were lower than 80% for the knowledge questions asking about the facts that - some patients may have no symptoms, diarrhea is a symptom of this disease and that it cannot be prevented by any currently available medication. Male gender, higher education, living in town/urban areas, good financial condition, and use of internet were positively associated with higher knowledge score among the non-medical participants. However, higher knowledge score was associated with having less confidence in the final control of COVID-19. Conclusion: Our study identified some COVID-19 information that were less known among the participants and the potential factors that were associated with having good versus poor knowledge. Besides, this study sheds light on the attitude of Bangladeshi adults towards COVID-19. [ABSTRACT FROM AUTHOR]

Background: The use of complementary and alternative medicine (CAM) among type 2 diabetes mellitus (T2DM) patients is increasing worldwide. It can affect optimum glycemic management. This study was to determine the rate and influencing factors of CAM use among diabetes patients as well as their effect on glycemic control. Methods: This cross-sectional study was conducted among T2DM patients attending the outpatient department of Rajshahi Medical College Hospital. It is a tertiary hospital in the northern part of Bangladesh. A face-to-face interview with a pretested structured questionnaire was used for data collection. Chi-square (χ2) test and multivariate logistic regression model were used in this study for data analysis. Results: Out of 244 T2DM patients, 86 (35.2%) used CAM. Multivariate logistic regression model showed that lower family income group (AOR = 8.7, 95% CI: 2.15–35.22, p-value 0.002), having no institutional education (AOR = 3.4, 95% CI: 1.17–9.87, p-value 0.025) and having diabetes for more than five years (AOR = 2.821, 95% CI: 1.34–5.94, p-value 0.006) were the most influential predictors of CAM use. The most commonly used CAMs were herbal products (67.4%) and homeopathic medicine (37.2%). Most of the CAM users (72%) were influenced by friends, neighbors, and family members. The most common reasons behind CAM use were reported to be the belief that CAM helped control diabetes better (44.2%) and easy availability and lower cost (27.9%). More than half of the users reported the efficacy of CAM as 'nothing significant', while others reported as somewhat good. 14% of CAM users experienced side-effects, especially gastrointestinal upset. It was observed that using CAM was associated with poor glycemic control (AOR = 2.25, 95% CI: 1.14–4.44, p-value 0.018). Conclusion: Our study demonstrated that some modifiable factors are associated with the use of CAM, and it cannot maintain good glycemic control. So, patients should be made aware of the ineffectiveness and bad effects of CAM by enhancing educational and poverty-alleviating programs. [ABSTRACT FROM AUTHOR]

Background and Objectives We aimed to explore experiences of South Asian carers of people with dementia receiving health or social care in the United Kingdom, purposively recruited to encompass a range of migration, economic and cultural experiences. While previous work in this area has reported carers' understanding of, and attitudes to dementia, we explored how carers' cultural identities and values influenced their experiences, negotiation of the caring role and relationship with services. Research Design and Methods We conducted semi-structured interviews with 10 Bangladeshi and Indian family carers of people living with dementia at home. We recruited participants from community settings in London and Bradford, UK. Interviews were audio recorded, transcribed and thematically analyzed. Results We identified 4 themes: an expectation and duty to care, expectation and duty as a barrier to accessing formal care (family carer reluctance, care recipient reluctance, and service organization), culturally (in)sensitive care, and the importance of support from informal care networks. Discussion and Implications Interviewees described tensions between generations with different understandings of familial care obligations. Expectations to manage led to burden and guilt, and the cost of caring, in terms of lost employment and relationships was striking. Unlike in previous studies, interviewees wanted to engage and be supported by services, but were frequently offered care models they could not accept. There was a tension between a state-provided care system obliged to provide care when there are no alternatives, and family carers who feel a duty to always provide alternatives. Informal social networks often provided valued support. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: In Bangladesh, 9.1% of people are disabled, but production and distribution of assistive products (AP) have not been sufficient up to now. Ensuring APs are in the market, and suggesting appropriate APs to the users, are two crucial points in Bangladesh, but there are no data about available APs and the awareness of rehabilitation professionals (RP). To improve this situation, this research was carried out to reveal the number of available APs and the awareness of RPs about APs. METHOD: Data from two important disability-oriented organizations in Bangladesh were collected, including RPs from those organizations. RESULTS: The result revealed that 23 out of 50 kinds of APs from the assistive products list (APL) of WHO were available in Bangladesh. In terms of awareness, an average of 24 APs from the APL were known by the RPs. Only 6% of RPs knew all the 23 APs available in Bangladesh. A total of 47% of RPs got information on APs from the internet, but 92% of them didn't know any database of APs. CONCLUSION: The study indicated that APs are insufficient, and the awareness of RPs about APs is inadequate in Bangladesh. [ABSTRACT FROM AUTHOR]

A high percentage of men and women are purported to justify intimate partner violence (IPV) in countries that are steeped in patriarchy even in the presence of programs such as microfinance that aim to address gender equity. This article examines two assertions that emerge from the literature on microfinance and its potential for positive outcomes for women who participate in it: (a) Microfinance participation is associated with reduced justification of IPV, and (b) microfinance participants with control over their own resources are less likely to justify IPV when compared with microfinance participants who do not have control over their resources. Couples data from a nationally representative survey, the Bangladesh Demographic and Health Survey, were used in the present study. Propensity score matching and logistic regression analyses were conducted to reveal that (a) microfinance participation was not associated with justification of IPV and that (b) women who participated in microfinance were less likely to justify IPV when they had no control over their resources. Implications for practitioners and policymakers are discussed. [ABSTRACT FROM AUTHOR]

Background: Allowing a broader range of trained health workers to deliver services can be an important way of improving access to safe abortion care. However, the expansion of health worker roles may be challenging to implement. This study aimed to explore factors influencing the implementation of role expansion strategies for non-physician providers to include the delivery of abortion care.Methods: We conducted a multi-country case study synthesis in Bangladesh, Ethiopia, Nepal, South Africa and Uruguay, where the roles of non-physician providers have been formally expanded to include the provision of abortion care. We searched for documentation from each country related to non-physician providers, abortion care services and role expansion through general internet searches, Google Scholar and PubMed, and gathered feedback from 12 key informants. We carried out a thematic analysis of the data, drawing on categories from the SURE Framework of factors affecting the implementation of policy options.Results: Several factors appeared to affect the successful implementation of including non-physician providers to provide abortion care services. These included health workers' knowledge about abortion legislation and services; and health workers' willingness to provide abortion care. Health workers' willingness appeared to be influenced by their personal views about abortion, the method of abortion and stage of pregnancy and their perceptions of their professional roles. While managers' and co-workers' attitudes towards the use of non-physician providers varied, the synthesis suggests that female clients focused less on the type of health worker and more on factors such as trust, privacy, cost, and closeness to home. Health systems factors also played a role, including workloads and incentives, training, supervision and support, supplies, referral systems, and monitoring and evaluation. Strategies used, with varying success, to address some of these issues in the study countries included values clarification workshops, health worker rotation, access to emotional support for health workers, the incorporation of abortion care services into pre-service curricula, and in-service training strategies.Conclusions: To increase the likelihood of success for role expansion strategies in the area of safe abortion, programme planners must consider how to ensure motivation, support and reasonable working conditions for affected health workers. [ABSTRACT FROM AUTHOR]

In many low- and middle-income countries, breast cancer survival is low. Reasons for this are multifactorial, but delayed presentation for care is a common theme. In this survey study with 100 urban Bangladeshi women, we examined the role of socioeconomic and sociocultural factors on their likelihood to seek breast care from a family physician. In our multivariate model, a woman's age and education significantly predicted her likelihood to see a physician. Sociocultural aspects (e.g., concerns about time commitment of family members, personal household obligations) were significant at bivariate level. Findings are discussed in relation to practice, policy, and research. [ABSTRACT FROM PUBLISHER]

The present research seeks to answer the question of what determines an uninvolved third party's forgiveness attitudes toward conflicting groups' violent partisan members. Specifically, Bangladeshi participants read a fictitious interview with a radicalized Palestinian who declared his intention to avenge himself against Israelis for his personal and collective plight by carrying out a suicide bombing attack. Findings reveal that an empathy manipulation (high empathy = other focused or low empathy = objective focused) influenced participants' forgiveness attitudes towards the radicalized Palestinian such that in the high empathy condition participants were more forgiving of the target than participants in the low empathy condition. Moreover, while the strength of their religious identification (Islam) played no significant role, participants' tendency to attribute the target's decision to situational factors fully mediated the effects of empathy on forgiveness. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to investigate factors that influence the adoption and use of e-Health applications in Bangladesh from citizens' (patients') perspectives by extending the technology acceptance model (TAM) to include privacy and trust.Methods: A structured questionnaire survey was used to collect data from more than 350 participants in various private and public hospitals in Dhaka, the capital city of Bangladesh. The data were analyzed using the partial least-squares (PLS) method, a statistical analysis technique based on structural equation modeling (SEM).Results: The study determined that perceived ease of use and perceived usefulness and trust (p < 0.05) were significant factors influencing the intention to adopt e-Health. Privacy (p > 0.05) was identified as a less significant factor in the context of e-Health in Bangladesh. The findings also revealed that gender was strongly associated with the adoption and use of e-Health services.Conclusions: The findings of the present study contribute to the development of strategies and policies to enhance e-Health services in Bangladesh. Furthermore, as a result of the generic approach used in this study, the acceptance model developed can be easily modified to investigate the adoption of e-Health in other developing countries. [ABSTRACT FROM AUTHOR]

South Asians are the third largest Asian group in the US and among the fastest growing racial groups in New Jersey. Tobacco consumption among South Asians is characterized by several smoked and smokeless tobacco products indigenous to the Indian subcontinent. However, there is a paucity of research on tobacco use behaviors among South Asians in the US. The goal of this study was to examine the awareness and use of South Asian tobacco products such as bidis, gutkha, paan, paan masala, and zarda as well as other potentially carcinogenic products such as supari, their context of use, and their cultural significance among South Asians living in the US. Eight focus groups were conducted with South Asian adults living in Central New Jersey. Overall, participants were aware of a wide variety of foreign and American tobacco products with older South Asians identifying a greater variety of indigenous products compared to younger South Asians. Hookah was consistently recognized as popular among the younger generation while products such as paan or paan masala were more commonly identified with elders. Use of tobacco-related products such as paan and supari were described as common at social gatherings or after meals. In addition, light or social users of South Asian tobacco products, including products not consistently defined as tobacco, may not report tobacco use on a survey. Better understanding of the use of these products among South Asians and how some may classify tobacco usage can inform future research and public health interventions in these communities. [ABSTRACT FROM AUTHOR]

Objective To examine the perceived effectiveness of text and pictorial smokeless tobacco health warnings in India and Bangladesh, including different types of message content. Methods An experimental study was conducted in Navi Mumbai, India (n=1002), and Dhaka, Bangladesh (n=1081). Face-to-face interviews were conducted on tablets with adult (≥19 years) smokeless tobacco users and youth (16-18 years) users and non-users. Respondents viewed warnings depicting five health effects, within one of the four randomly assigned warning label conditions (or message themes): (1) text-only, (2) symbolic pictorial, (3) graphic pictorial or (4) personal testimonial pictorial messages. Results Text-only warnings were perceived as less effective than all of the pictorial styles (p<0.001 for all). Graphic warnings were given higher effectiveness ratings than symbolic or testimonial warnings ( p<0.001). No differences were observed in levels of agreement with negative attitudes and beliefs across message themes, after respondents had viewed warnings. Conclusions Pictorial warnings are more effective than text-only messages. Pictorial warnings depicting graphic health effects may have the greatest impact, consistent with research from high-income countries on cigarette warnings. [ABSTRACT FROM AUTHOR]

Community health workers (CHWs) have strong potential to extend health and nutrition services to underserved populations. However, CHWs face complex challenges when working within weak health systems and among communities with limited abilities to access and utilise CHW services. It is crucial to understand these challenges to improve programme support mechanisms. This study describes the results of qualitative investigations into CHW perceptions of barriers to quality of care among two groups of workers implementing community case management of acute respiratory infection, diarrhoea and severe acute malnutrition in southern Bangladesh. We explored systemic barriers to service delivery, pertaining to communities and health systems, which limited the usefulness and effectiveness of CHW services. Focus group discussions (n = 10) were conducted in March 2010. Discussions were analysed for themes related to CHWs' work challenges. Findings highlight several perceived barriers to effective service provision, including community poverty constraining uptake of recommended practices, irregular supplies of medicine from the health facility and poor quality of care for CHW referrals sent there. This study further documents interactions between demand‐side and supply‐side constraints including the influence of health system resource constraints on community trust in CHW services, and the influence of community resource constraints on the utilisation and effectiveness of CHW services. By documenting service delivery challenges from the perspective of the frontline workers themselves, this article contributes evidence to help identify appropriate support mechanisms for these workers, in order to develop scalable and sustainable CHW programmes in countries with under‐resourced public health care infrastructure. [ABSTRACT FROM AUTHOR]

This study uses the Bangladesh Demographic and Health Survey-2007 to identify factors associated with Intimate Partner Violence (IPV) for currently married Bangladeshi women. Twenty five percent of women reported experiencing at least one form of IPV. The most prevalent form of IPV is slapping; and, according to respondents, the main reason given for IPV is without any reason. However, results show that women who think their husbands are justified in beating them, and who witnessed their fathers hit or beat their mothers, are more likely to experience IPV. Results revealed that such women are, respectively, 1.21 and 2.37 times more likely to experience violence than their counterparts. Therefore, these two important factors need urgent attention to reduce IPV against women in Bangladesh. [ABSTRACT FROM AUTHOR]

Improved infant and young child feeding ( IYCF) practices have the potential to improve child health and development outcomes in poorly resourced communities. In Bangladesh, approximately 60% of rural girls become mothers before the age of 18, but most interventions to improve IYCF practices target older mothers. We investigated the knowledge, attitudes and perceptions regarding IYCF among adolescent girls and young women aged 15-23 years old in two rural regions in north-west Bangladesh and identified the main points of concordance with, or mismatch to, key international IYCF recommendations. We compared qualitative data collected during interviews and focus groups with participants who were unmarried, married without a child and married with at least one child, and stratified by region. Qualitative indicators of concordance with international recommendations suggest that IYCF knowledge of participants was limited, irrespective of marriage or maternity. Young mothers in our study were no more knowledgeable about feeding practices than their nulliparous peers. Some participants were well aware of an IYCF recommendation (e.g. to exclusively breastfeed for 6 months), but their interpretation of the recommendation deviated from the intended public health message. Notions of insufficient or 'spoiled' breast milk, gender-based biases in feeding intentions and understandings of infant needs, and generational shifts in feeding practices were commonly reported. Conclusions are that female adolescence is a window of opportunity for improving health outcomes among future children, and increased investment in early education of adolescent girls regarding safe IYCF may be an effective strategy to promote and support improved infant feeding practices. [ABSTRACT FROM AUTHOR]

Despite worldwide initiatives, the exclusive breastfeeding (EBF) rate is low. The study aims to investigate the role of fathers' knowledge, attitude and support in formulating mothers' practice of breastfeeding taking Bangladeshi parental cases as a sample. The study uses a standard survey instrument following the theory of planned behavior (TPB). Responses from 332 couples are accepted following a standard criteria and used for analysis. The sample is divided into sub-groups based on delivery mode—vaginal (n = 211, 64%) and cesarean section (n = 121, 36%). Based on the sub-groups, a multi-group structural equation modelling (SEM) is applied to analyze the phenomena. The study finds that a father's knowledge in EBF can, in one way, significantly enhance mother's knowledge by sharing and, in another way, can enhance his own attitude to offer different support to his partner/wife which induces the chances of EBF practices by mothers. The enhanced EBF knowledge of a mother raises her attitude to practice EBF, which is also positively affected by the father's attitude. Thus, fathers' support, coupled with mothers' positive attitude, the mother's intention to practice EBF as per standard guidelines. [ABSTRACT FROM AUTHOR]

The use of antibiotics in animals for both therapeutic and non-therapeutic purposes is a major driver of the emergence and spread of antimicrobial resistance (AMR). While several studies have investigated prescription and consumption patterns in humans, little attention has been paid to the veterinary sector. A cross-sectional study was conducted in 3002 veterinary students (VS) and non-medical students (NMS) from 12 universities in Bangladesh to explore their knowledge, attitudes and practices (KAP) about antibiotics and AMR using a self-administered questionnaire, and assess the influence of the veterinary curriculum. KAP regarding antibiotic use and AMR was significantly higher in veterinary than non-medical students, and in first-year than final-year students. However, gaps in knowledge and practices were highlighted, suggesting deficiencies in training. Moreover, final-year veterinary students were found to be more likely than first-year students to use antibiotics without instructions, which could indicate deficiencies in their curriculum. Although the study suggested a positive impact of the veterinary curriculum on KAP about antibiotics and AMR in Bangladesh, critical gaps remain that are likely to contribute to inadequate use in their future practice. Therefore, there is scope for improving educational programs on AMR in professional curricula. [ABSTRACT FROM AUTHOR]

Background: The pharmaceutical market in Bangladesh is highly concentrated (top ten control around 70 % of the market). Due to high competition aggressive marketing strategies are adopted for greater market share, which sometimes cross limit. There is lack of data on this aspect in Bangladesh. This exploratory study aimed to fill this gap by investigating current promotional practices of the pharmaceutical companies including the role of their medical representatives (MR).Methods: This qualitative study was conducted as part of a larger study to explore the status of governance in health sector in 2009. Data were collected from Dhaka, Chittagong and Bogra districts through in-depth interview (healthcare providers and MRs), observation (physician-MR interaction), and round table discussion (chief executives and top management of the pharmaceutical companies).Results: Findings reveal a highly structured system geared to generate prescriptions and ensure market share instituted by the pharmaceuticals. A comprehensive training curriculum for the MRs prepares the newly recruited science graduates for generating enough prescriptions by catering to the identified needs and demands of the physicians expressed or otherwise, and thus grab higher market-share for the companies they represent. Approaches such as inducements, persuasion, emotional blackmail, serving family members, etc. are used. The type, quantity and quality of inducements offered to the physicians depend upon his/her capacity to produce prescriptions. The popular physicians are cultivated meticulously by the MRs to establish brand loyalty and fulfill individual and company targets. The physicians, willingly or unwillingly, become part of the system with few exceptions. Neither the regulatory authority nor the professional or consumer rights bodies has any role to control or ractify the process.Conclusions: The aggressive marketing of the pharmaceutical companies compel their MRs, programmed to maximize market share, to adopt unethical means if and when necessary. When medicines are prescribed and dispensed more for financial interests than for needs of the patients, it reflects system's failed ability to hold individuals and entities accountable for adhering to basic professional ethics, code of conduct, and statutory laws. [ABSTRACT FROM AUTHOR]